Home Menu

Performance Matters

The LMC is regularly involved in representing and supporting doctors who have been identified as having "performance" issues. The LMC has identified a number of themes which recur, and this regular feature from our newsletter will highlight these, so that our members can avoid these pitfalls.

Back Pain in the Older Patient

Back pain is a very common problem for general practice patients, and most of the time it does not have a sinister cause. However, at recent serious case reviews there have been a number of cases where back pain in older patients has been the first presentation of more sinister diagnoses.

When assessing any patient with back pain the European Back Pain guidelines recommended an initial assessment of "red flags". Red flags are signs in addition to low back pain. These include: Read more...

Blood Test Results

We all receive, deal with, and file, hundreds of blood test results every week.  In the vast majority of cases this is a seamless and uncomplicated process.  However, over recent months a number of cases have been discussed at performance panels where the main concern has been due to incorrectly filed blood test results, or results not being actioned correctly once filed. Read more...

Commonly Missed Diagnosis

We all know that we make mistakes, and we learn from these mistakes. We also know that we are likely to miss certain diagnoses. The Practitioner Performance Team is, thankfully, realistic about this, and supports GPs who miss uncommon diagnoses. However, when doctors miss common diagnoses they are less supportive. Read more..

Consent

Not getting adequate consent is the fourth most common cause for medical indemnity claims[1].  It also accounts for high proportion of the cases which are taken to the GMC and local Performance Groups.

When consent is not adequately obtained, and a claim arises, 75% of claims are settled without going to court.[2]  This suggests that not getting adequate consent is indefensible. Read more...

Gillick-Fraser Competence

GPs frequently see patients who are aged under 18 years of age without the parents being present. If the GP decides to treat these patients without parental knowledge or consent parents may complain about the doctor’s actions. It is thus essential that all GPs understand the rules and guidelines which pertain to treating non-adults. Read more...

Interruptions

It is well documented that interruptions during consultations are upsetting to both doctors and patients.  About 10% of GP consultations are interrupted for one reason or another.  When surveyed, patients felt that over 50% of these interruptions were unnecessary, and 20% felt that the interruption had a negative impact on the consultation. Read more...

Medication Reviews & Repeat Prescribing of Potentially Harmful Drugs

Medication and prescribing errors can cause significant patient harm, and thus can lead to complaints and referral to the Practitioner Performance Team (PPT) or GMC. When these complaints are investigated, the PPT will look at the index case, and also at the records of patients who have been prescribed similar drugs by the practitioner. Read more...

Parental Responsibility

A recent safeguarding Serious Case Review (SCR Family V, published on the Lincolnshire LSCB website) highlighted the importance of knowing who has parental responsibility for a child. In this case, a man had repeatedly taken a child to multiple medical appointments, and the child had received treatment, despite the fact that the man did not have parental responsibility for the child.Read more...

Prescribing to Vulnerable Adults

A vulnerable adult is defined in "No Secrets‟ Governments Guidance of Adult Abuse as:

"someone who is aged 18 and over, who is or may be in need of community care services by reason of mental or other disability, age, or illness and who is or may be unable to take care of him/herself and protect him/herself against significant harm or exploitation and those who are ill or dependent upon another for any of the aids to daily living" Read more...

Sepsis

Sepsis is, if you pardon the pun, a hot topic currently.  High profile cases and pressure from groups such as Sepsis Trust UK have pushed sepsis up the political and performance agenda.  This higher profile, and a number of recent performance cases, has prompted us to encourage practices to have very tight protocols and procedures to help identify patients with sepsis. Read more...

Related guidance...

Back Pain in the Older Patient

Back pain is a very common problem for general practice patients, and most of the time it does not have a sinister cause. However, at...

Commonly Missed Diagnoses

We all know that we make mistakes, and we learn from these mistakes. We also know that we are likely to miss certain diagnoses. The...

Sepsis

Sepsis is, if you pardon the pun, a hot topic currently. High profile cases and pressure from groups such as Sepsis Trust UK have...

Medication Reviews & Repeat Prescribing of Potentially Harmful Drugs

Medication Reviews Medication and prescribing errors can cause significant patient harm, and thus can lead to complaints and referral...

Interruptions

It is well documented that interruptions during consultations are upsetting to both doctors and patients. About 10% of GP consultations...

Performance Matters - Unwell Children

The LMC is regularly involved in representing and supporting doctors who have been identified as having 'performance' issues. The LMC...

Parental Responsibility

A recent safeguarding Serious Case Review (SCR Family V, published on the Lincolnshire LSCB website) highlighted the importance of...

Consent

Not getting adequate consent is the fourth most common cause for medical indemnity claims[1]. It also accounts for high proportion of...

November newsletter

This newsletter includes articles on; Marketing Lincolnshire General Practice - BMJ Careers Fair Performance Matters - Back Pain in...

Gillick-Fraser Competence

GPs frequently see patients who are aged under 18 years of age without the parents being present. If the GP decides to treat these...